Frequently asked questions about Medicare Part B welcome and wellness exams
What is the Initial Preventive Physical Examination (IPPE)?
The IPPE, otherwise known as the “Welcome to Medicare” visit, is strictly for those patients new to Medicare. This a one-time only exam paid for by Medicare for beneficiaries who have enrolled in the Medicare Part B program within the last 12 months.
Please note, this is not a comprehensive physical exam. The visit includes the following:
- Physical examination
- Electrocardiogram (EKG) - optional
- Health education, counseling and referral to other screening and preventive services covered by Medicare
You should bring the following items with you to this appointment:
- Medical records, including immunization records
- Family health history – before your appointment, try to learn as much as you can about your family's health history. Any information you can give your doctor can help determine if you’re at risk for certain diseases
- A list of prescription drugs and over-the-counter medications that you currently take, how often you take them and why
It is important to note that, with the exception of this initial exam, Medicare does not cover routine physical exams. After the visit, your doctor will provide you with a plan or checklist outlining the screenings and preventative services you should get.
How is the IPPE different than the annual wellness visit?
Medicare Part B coverage allows for an Annual Wellness Visit (AWV) one-year after your Initial Preventive Physical Examination (IPPE) and yearly thereafter. At your AWV you and your primary health care provider will update your medical records, determine health concerns based on your medical/family history and perform a simple examination to assess your weight, body mass index and blood pressure.
You are eligible for an “annual wellness visit” 12 months after the date of your “welcome to Medicare” visit. This visit is a strategy session designed to help you and your primary care provider develop an ongoing health plan intended to keep you healthy, safe, and independent for a long time. The AWV includes the following:
- Routine measurements such as height, weight, and blood pressure
- Review of medical and family history
- Establishing a comprehensive list of all of the physicians treating you and current medications
- Personal risk assessment
- Review of functional ability and level of safety
- Creating a schedule for Medicare's screening and preventive services over the next five to 10 years
An AWV is not a physical examination or a preventive medicine service and does not include medication refills, routine physical checkups or services for new or existing health problems. These services will require an extended visit, which will be billed separately and may not be covered by Medicare.
Is the annual wellness visit the same thing as an annual physical exam?
No. The annual wellness visit is not a physical. An annual physical is a more extensive physical examination. In addition to collecting a medical history, a physical may also include:
- Head and neck exam
- Heart and lung exam
- Abdominal exam
- Neurological exam
- Dermatological exam
- Extremities exam
You may choose to have a physical at another visit, but Medicare will not pay for this service.
If you have a Medicare Advantage or other type of Medicare replacement plan, you will need to see if the plan pays for an annual physical; otherwise, you will be responsible for payment.
What does the annual wellness visit cost?
You pay nothing out of pocket for this visit. However, you may be responsible for a deductible or co-pay expense if additional evaluation is required.
When am I eligible for my annual wellness visit?
You are eligible for the annual wellness visit after you have had Medicare Part B for more than 12 months. However, if you've had a “Welcome to Medicare” visit within the last 12 months, you must wait 12 months from that visit before you can have your annual wellness visit.
How often can I have my annual wellness visit?
You may have an annual wellness visit once every 12 months.
Will I actually see a doctor during the annual wellness visit?
You will see your primary care provider, who could be a physician, nurse practitioner, or physician assistant.
Depending on which clinic you go to, you may also spend time with nursing staff or other medical professionals who will help gather your medical history so that your health care provider can determine an appropriate preventive health screening plan.
How do I schedule my annual wellness visit?
To determine when you become eligible for your first Medicare annual wellness visit, call your primary care provider’s office.
What if I do not have a primary care provider?
Call 1 (888) 825-3227 to for assistance with finding a Franciscan Medical Group primary care provider.